Dismissal Due to Business Reasons in Italy

TABLE OF CONTENT: Introduction. – 1. How are the causes that justify a redundancy or a dismissal due to business reasons defined? – 2. The business reasons that justifying the dismissal, must they concur in the entire company or only concur in the workplace where dismissal occurs? – 3. What is the procedure that the company must follow to conduct a dismissal for business reasons? Are there specialties in such procedure in cases of redundancies (that is, when there is a collective dismissal)? – 3.1. Individual dismissal – 3.2. Collective dismissal. – 4. How is the number of affected workers calculated in order to determine the individual or collective nature of the dismissal? – 5. Are there groups of workers who have priority in a dismissal for business reasons? Particularly, do workers’ representatives have priority? And pregnant workers? Elder workers? Workers with family responsibilities? – 5.1. Individual dismissal. – 5.2. Collective dismissal. – 6. Are workers affected by a dismissal due to business reasons entitled to an economic compensation? – 7. What obligations does the company that carries out a dismissal due to business reasons have? In particular, is there the obligation to relocate affected workers within the company or the group of companies? – 8. What are the consequences that arise from breach or non-compliance with the legal procedure regarding dismissals due to business reasons? In which cases is the dismissal considered null (that is, that implies the worker’s readmission)? – 8.1. Individual dismissal. – 8.2. Collective dismissal. – 9. Are there specialties in the dismissal due to business reasons for microcompanies and/or small and medium enterprises? – 9.1. Individual dismissal. – 9.2. Collective dismissal. – 10. Is it possible to conduct a dismissal due to business reasons in a public administration? In this case, what specialties exist in regard to the definition of the business causes? – 11. Other relevant aspects regarding dismissals due to business reasons

Subclinical and clinical atherosclerosis in Non-alcoholic Fatty Liver Disease is associated with the presence of hypertension

Background and aims Non-alcoholic fatty liver disease (NAFLD) is associated with increased cardiovascular risk. However, whether NAFLD contributes independently to the development of cardiovascular disease is not fully understood. Our study aimed at assessing the differences in several indices of atherosclerosis, arterial stiffness and cardiac morphology among patients with isolated NAFLD, isolated hypertension (HT) or with combination of the two conditions. Methods and results One hundred and sixty-nine participants (mean age=50.4±10.2 yrs; males=73.6 %) were divided according to the presence of NAFLD and HT in three groups: only-NAFLD (55 patients), only-HT (49 patients) and NAFLD+HT (65 patients). Exclusion criteria were BMI≥35Kg/m2 and presence of diabetes mellitus. Carotid ultrasonography was performed to measure markers of atherosclerosis and arterial stiffness. Cardiac remodeling was analyzed using echocardiography. Prevalence of subclinical and overt atherosclerosis was significantly higher in the NAFLD+HT patients as compared to the other two groups (atherosclerotic plaques: 43.1%, 10.9%, 22.4% (p<0.001), in NAFLD+HT, NAFLD and HT groups). No differences were found among indices of arterial stiffening and cardiac remodeling across the three groups. In multivariate regression analysis the coexistence of NAFLD and HT was an independent risk factor for overt atherosclerosis (OR=4.88; p=0.03), while no association was found when either NAFLD or HT was considered alone. Conclusion Overt atherosclerosis was significantly present only in NAFLD+HT patients, but not in patients presenting with isolated NAFLD. This implies that the impact of NAFLD on vascular structure and function could depend on the coexistence of other major cardiovascular risk factors, such as HT

Static Requirement and Type’s Complexity in the Diagnostics Phase

The preservation of a historical building, whatever its architectural or artistic value, is more effective when based on an in-depth understanding of the building’s development, materials and constructive techniques. In fact, the protection and conservation of heritage buildings entails varied and sometimes even alarming aspects; however, they help us to identify the commonly called “architectural emergency”. This is essentially related to the size and the great number of cases to resolve and – together - to the limited availability of usable resources and experiences. So, it’s necessary to optimize in a better way the limited finances and resources allocated to restoration efforts. Faced with a degraded monument, the renovation designer must answer three main questions: “if” to perform a restoration, “where” to perform a restoration and “how” to perform a restoration. To these questions it is possible to add another one that regarding the economic aspect: “when” to perform a restoration intervention . In order to respond adequately to these questions, it is necessary to advance “step by step”, through easily defined procedures: the identification of degradation, the determination of its causes, the assessment of residual safety and, finally, the appropariate intervention and definition of its execution method. So the preliminary action is the research of all information about the monuments; this information is required to describe the structure and all the transformations that it has suffered; in this situation, it becomes essential to know the history of the building, from its construction until the last modification that it has undergone. In the first phase of data acquisition, the direct recognition of the building characteristics and the survey of the checked alteration, should be complemented by research of design documentation and of events that have affected the structure during all its life cycle

The AST/ALT (De-Ritis) ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients

The aspartat aminotransferase (AST)/alanin aminotransferase (ALT) (De-Ritis) ratio (AAR) is an easily applicable blood test. An elevated AAR on the one hand has been associated with an increase in nonalcoholic fatty liver disease (NAFLD). NAFLD on the other hand is associated with an increase in cardiovascular disease, all-cause mortality, and diabetes. As the AAR is also elevated in case of muscular damage, we investigated AAR and its association with critical limb ischemia (CLI) in peripheral arterial occlusive disease (PAOD) patients. In our cross-sectional study, we included 1782 PAOD patients treated at our institution from 2005 to 2010. Patients with chronic alcohol consumption (>20 g/day) were excluded. AAR was calculated and the cohort was categorized into tertiles according to the AAR. An optimal cut-off value for the continuous AAR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort, occurrence of CLI significantly increased with an elevation in AAR. As an optimal cut-off value, an AAR of 1.67 (sensitivity 34.1%, specificity 81.0%) was identified. Two groups were categorized, 1st group containing 1385 patients (AAR < 1.67) and a 2nd group with 397 patients (AAR > 1.67). CLI was more frequent in AAR > 1.67 patients (166 [41.9%]) compared to AAR < 1.67 patients (329 [23.8%]) (P < 0.001), as was prior myocardial infarction (28 [7.1%] vs 54 [3.9%], P = 0.01). Regarding inflammatory parameters, C-reactive protein (median 8.1 mg/L [2.9–28.23] vs median 4.3 mg/L [2.0–11.5]) and fibrinogen (median 427.5 mg/dL [344.25–530.0] vs 388.0 mg/dL [327.0–493.0]) also significantly differed in the 2 patient groups (both P < 0.001). Finally, an AAR > 1.67 was associated with an odds ratio (OR) of 2.0 (95% confidence interval [CI] 1.7–2.3) for CLI even after adjustment for other well-established vascular risk factors. An increased AAR is significantly associated with patients at high risk for CLI and other cardiovascular endpoints. The AAR is a broadly available and cheap marker, which might be useful to highlight patients at high risk for vascular endpoints

The multifaceted spectrum of liver cirrhosis in older hospitalised patients: Analysis of the REPOSI registry

Background: Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives: To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. Methods: A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. Results: LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&amp;M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P &lt; 0.05) compared to FIT. D&amp;M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P &lt; 0.01; post-discharge: 41% vs 12%/15%, P &lt; 0.01) and less rehospitalisation (10% vs 32%/34%, P &lt; 0.01) compared to PSS and FIT. Conclusions: LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features

From Geophysics to Microgeophysics for Engineering and Cultural Heritage

The methodologies of microgeophysics have been derived from the geophysical ones, for the sake of solving specific diagnostic and/or monitoring problems regarding civil engineering and cultural heritage studies. Generally, the investigations are carried out using different 2D and 3D tomographic approaches as well as different energy sources: sonic and ultrasonic waves, electromagnetic (inductive and impulsive) sources, electric potential fields, and infrared emission. Many efforts have been made to modify instruments and procedures in order to improve the resolution of the surveys as well as to significantly reduce the time of the measurements without any loss of information. This last point has been achieved by using multichannel systems. Finally, some applications are presented, and the results seem to be very promising and promote this new branch of geophysics. Therefore, these methodologies can be used even more to diagnose, monitor, and safeguard not only engineering buildings and/or large structures, but also ancient monuments and cultural artifacts, such as pottery, statues, and so forth

Effect of cross section aspect ratio and bearing surfaces treatment on the compressive strength of solid fired clay brick specimens

This study addresses the evaluation of the confinement effect in the experimental determination of compressive strength in solid fired clay units. The experimental campaign has focused on two different types of solid fired clay bricks, namely mechanically extruded and handmade, with a total amount of 458 specimens. The research considers different standard specimens, such as whole or half brick, and 100 × 100 × 40 mm3 specimen, and nonstandard 40 × 40 × 40 mm3 specimen, subjected to different standard bearing surface treatments, i.e. grinding, capping with cement mortar or gypsum plaster, placing with birch plywood or fibreboard. Additionally, two novel bearing surface treatments are proposed, i.e. covering with gypsum powder, and placing two oiled PTFE leaves. The experimental campaign has focused on four main aspects. First, the evaluation of the compressive strength value in specimens with hardening response. Second, the influence of the cross section’s aspect ratio, defined as the ratio between the specimen’s length and width. Third, the influence of the bearing surface treatment on the determination of the compressive strength. Fourth, the evaluation of the standard compressive strength through the comparison amongst reference standards. The results highlight and quantify the different factors that influence the confinement, while detecting differences depending on the manufacturing process of the unit. In addition, the results reveal the use of oiled PTFE leaves as a promising and fast possibility of low boundary friction to obtain the strength regardless of the specimen shape.The authors gratefully acknowledge the financial support from the Ministry of Science, Innovation and Universities of the Spanish Government (MCIU), the State Agency of Research (AEI) as well as that of the ERDF (European Regional Development Fund) through the project SEVERUS (Multilevel evaluation of seismic vulnerability and risk mitigation of masonry buildings in resilient historical urban centres, ref. Num. RTI2018-099589-B-I00). Support from MCIU through a predoctoral grant awarded to the first author is also gratefully acknowledged.Peer ReviewedPostprint (published version

Non-alcoholic fatty liver disease: relationship with cardiovascular risk markers and clinical endpoints

Non-alcoholic fatty liver disease (NAFLD) is a common diagnosis and is increasing in prevalence worldwide. NAFLD is usually asymptomatic at presentation; progression of the disease is unpredictable, leading to the development of a variety of techniques for screening, diagnosis and risk stratification. Clinical methods in current use include serum biomarker panels, hepatic ultrasound, magnetic resonance imaging, and liver biopsy. NAFLD is strongly associated with the metabolic syndrome, and the most common cause of death for people with the condition is cardiovascular disease. Whether NAFLD is an independent cardiovascular risk factor needs exploration. NAFLD has been associated with surrogate markers of cardiovascular disease such as carotid intima-media thickness, the presence of carotid plaque, brachial artery vasodilatory responsiveness and CT coronary artery calcification score. There is no effective medical treatment for NAFLD and evidence is lacking regarding the efficacy of interventions in mitigating cardiovascular risk. Health care professionals managing patients with NAFLD should tackle the issue with early identification of risk factors and aggressive modification. Current management strategies therefore comprise lifestyle change,with close attention to known cardiovascular risk factors

Reactive hyperemia index (RHI) and cognitive performance indexes are associated with histologic markers of liver disease in subjects with non-alcoholic fatty liver disease (NAFLD): a case control study.

BACKGROUND: No study evaluated vascular health markers in subjects with non-alcoholic fatty liver disease (NAFLD) through a combined analysis of reactive hyperemia peripheral arterial tonometry (RH-PAT) and arterial stiffness indexes. AIM OF THE STUDY: We aimed to assess whether NAFLD and its histological severity are associated with impairment of arterial stiffness and RH-PAT indexes in a mixed cohort of patients with biopsy-proven NAFLD. MATERIALS AND METHODS: The Kleiner classification was used to grade NAFLD grade. Pulse wave velocity (PWV) and augmentation index (Aix) were used as markers of arterial stiffness, whereas endothelial function was assessed using reactive hyperemia index (RHI). The mini-mental state examination (MMSE) was administered to test cognitive performance. RESULTS: 80 consecutive patients with biopsy-proven NAFLD and 83 controls without fatty liver disease. NAFLD subjects showed significantly lower mean RHI, higher mean arterial stiffness indexes and lower mean MMSE score. Multivariable analysis after correction for BMI, dyslipidaemia, hypertension, sex, diabetes, age and cardiovascular disease showed that BMI, diastolic blood pressure and RHI are significantly associated to NAFLD. Simple linear regression analysis showed among non-alcoholic steatohepatitis (NASH) subjects a significant negative relationship between ballooning grade and MMSE and a significant positive association between Kleiner steatosis grade and augmentation index. CONCLUSIONS: Future research will be addressed to evaluate the relationship between inflammatory markers and arterial stiffness and endothelial function indexes in NAFLD subjects. These study will evaluate association between cardiovascular event incidence and arterial stiffness, endothelial and cognitive markers, and they will address the beneficial effects of cardiovascular drugs such as statins and ACE inhibitors on these surrogate markers in NAFLD subjects